Endoscopic Submucosal Dissection for Early Gastric Neoplasms in Elderly Patients

2014 ◽  
Vol 24 (6) ◽  
pp. 391-398 ◽  
Author(s):  
Yan Zhang ◽  
Lijiang Huang ◽  
Lin Li ◽  
Feng Ji
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Gastric Neoplasms ◽  
Submucosal Dissection

Sa1508 Long-Term Follow-up of Extremely Elderly Patients With Early Gastric Neoplasms Treated by Endoscopic Submucosal Dissection

2014 ◽  
Vol 79 (5) ◽  
pp. AB239
Author(s):  
Tatsuya Toyokawa ◽  
Tomoki Inaba ◽  
Koichi Izumikawa ◽  
Isao Fujita ◽  
Shigenao Ishikawa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Gastric Neoplasms ◽  
Submucosal Dissection ◽  
Long Term Follow Up

scholarly journals Advanced Colon Cancer after Curative Resection of Intramucosal Adenocarcinoma with Endoscopic Submucosal Dissection

2021 ◽  
pp. 603-609
Author(s):  
Akiko Sasaki ◽  
Chikamasa Ichita ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Advanced Cancer ◽  
Curative Resection ◽  
Submucosal Tumor ◽  
R0 Resection ◽  
Surveillance Colonoscopy ◽  
Epithelial Tumor ◽  
Submucosal Dissection ◽  
Intramucosal Adenocarcinoma

Endoscopic resection, particularly endoscopic submucosal dissection (ESD), for colorectal cancers enables a precise pathological diagnosis and safe R0 resection. The recurrence rate after ESD is generally extremely low, with annual surveillance colonoscopy recommended. However, surveillance may not be considered for super-elderly patients owing to their condition. This is a case report of an 85-year-old man in whom curative resection was achieved for an intramucosal adenocarcinoma with ESD. The patient presented with a hypoechoic mass located in his lower right abdomen, diagnosed via surveillance abdominal ultrasound. He had undergone curative ESD for intramucosal cecal cancer 2 years prior. Colonoscopy revealed a type 2 epithelial tumor at the proximal aspect of the ESD scar. Ileocolic resection with lymph node dissection was performed. An epithelial tumor and well-differentiated adenocarcinoma but not a submucosal tumor was detected in the mucosal layer. The lesion was diagnosed not as a local recurrence after ESD but as a newly emerged original advanced cancer. After ESD for colorectal cancer, a newly developed advanced cancer may occur at the site of the ESD scar in a shorter term than usual. Surveillance colonoscopy after ESD is necessary even for super-elderly patients.

scholarly journals Impact of Comorbidities, Sarcopenia, and Nutritional Status on the Long-Term Outcomes after Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients Aged ≥ 80 Years

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3598
Author(s):  
Ga Hee Kim ◽  
Kee Don Choi ◽  
Yousun Ko ◽  
Taeyong Park ◽  
Kyung Won Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Early Gastric Cancer ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Term Survival ◽  
Factors Associated ◽  
Submucosal Dissection

Background/Aim: We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. Methods: Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. Results: The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90–0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03–1.37; p = 0.018) were significant factors associated with overall survival. Conclusions: ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.

Dive to the Underwater World: A Water Immersion Technique for Endoscopic Submucosal Dissection of Gastric Neoplasms

2017 ◽  
Vol 112 (7) ◽  
pp. 985 ◽  
Author(s):  
Tomofumi Akasaka ◽  
Yusuke Tonai ◽  
Kenta Hamada ◽  
Yoji Takeuchi ◽  
Noriya Uedo ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Water Immersion ◽  
Gastric Neoplasms ◽  
Submucosal Dissection ◽  
Immersion Technique

scholarly journals Polysaccharide hemostatic powder to prevent bleeding after endoscopic submucosal dissection in high risk patients: A randomized controlled trial

Endoscopy ◽  
2020 ◽  
Author(s):  
Da Hyun Jung ◽  
Chan Hyuk Park ◽  
Hee Seok Moon ◽  
Jun Chul Park
Keyword(s):  
High Risk ◽  
Endoscopic Submucosal Dissection ◽  
Controlled Trial ◽  
Gastric Neoplasms ◽  
Control Group ◽  
High Risk Patients ◽  
Randomized Controlled ◽  
Submucosal Dissection ◽  
Risk Patients ◽  
Hemostatic Powder

Background and aims: Bleeding after endoscopic submucosal dissection (ESD) is a severe adverse event. Several methods to prevent post-ESD bleeding (PEB) have been introduced; however, they have not been widely used because of technical difficulties. We aimed to investigate whether polysaccharide hemostatic powder (PHP), which is very easy to apply, can prevent early PEB, especially in patients with high risk of PEB. Methods: This was a prospective, multicenter, randomized, open-label, controlled trial. Patients with a high risk for PEB were enrolled. Patients with gastric neoplasms in whom the resected specimen size was expected to be >40 mm and those who were regularly taking antithrombotic agents were defined as high-risk patients. Patients were randomly assigned to the PHP or control group. Results: Between May 2017 and September 2018, 143 patients were enrolled (PHP group: 73, control group: 70). The total PEB rate was 6.3% (PHP group: 5% vs. control group: 7.1%, P=0.742). There was no bleeding within 7 days after ESD in the PHP group. Continued antithrombotic use was an independent risk factor of PEB. In subgroup analysis excluding patients who continued to take antithrombotics (n=129) during ESD, the rate of PEB was tended to be lower in the PHP group than in the control group (0% vs. 6.3%, P=0.058). Conclusion: PHP did not demonstrate a significant effect on the prevention of PEB in this study. Further larger-scale, randomized controlled trials are needed to confirm this.(ClinicalTrials.gov 03169569)

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